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001-es BibID:BIBFORM034529
Első szerző:Grob, Dieter
Cím:A prospective, cohort study comparing translaminar screw fixation with transforaminal lumbar interbody fusion and pedicle screw fixation for fusion of the degenerative lumbar spine / Grob, D., Bartanusz, V., Jeszenszky, D., Kleinstuck, F. S., Lattig, F., O'Riordan, D., Mannion, A. F.
Dátum:2009
ISSN:0301-620X
Megjegyzések:In a prospective observational study we compared the two-year outcome of lumbar fusion by a simple technique using translaminar screws (n = 57) with a more extensive method using transforaminal lumbar interbody fusion and pedicular screw fixation (n = 63) in consecutive patients with degenerative disease of the lumbar spine. Outcome was assessed using the validated multidimensional Core Outcome Measures Index. Blood loss and operating time were significantly lower in the translaminar screw group (p < 0.01). The complication rates were similar in each group (2% to 4%). In all, 91% of the patients returned their questionnaire at two-years. The groups did not differ in Core Outcome Measures Index score reduction, 3.6 (sd 2.5) (translaminar screws) vs 4.0 (sd 2.8) (transforaminal lumbar interbody fusion) (p = 0.39); 'good' global outcomes, 78% (translaminar screws) vs 78% (transforaminal lumbar interbody fusion) (p = 0.99) or satisfaction with treatment, 82% (translaminar screws) vs 86% (transforaminal lumbar interbody fusion) (p = 0.52). The two fusion techniques differed markedly in their extent and the cost of the implants, but were associated with almost identical patient-orientated outcomes. Extensive three-point stabilisation is not always required to achieve satisfactory patient-orientated results at two years.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Journal Of Bone And Joint Surgery-British Volume. - 91-B : 10 (2009), p. 1347-1353. -
További szerzők:Bartanusz, Viktor Jeszenszky Dezső (1954-) (idegsebész, ortopédus) Kleinstück, Frank S. Lattig, Friederike O'Riordan, David Mannion, Anne F.
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2.

001-es BibID:BIBFORM034530
Első szerző:Kleinstück, Frank S.
Cím:The Influence of Preoperative Back Pain on the Outcome of Lumbar Decompression Surgery / Kleinstück Frank S., Grob Dieter, Lattig Friederike, Bartanusz Viktor, Porchet Francois, Jeszenszky Dezsö, O'Riordan David, Mannion Anne F.
Dátum:2009
ISSN:0362-2436
Megjegyzések:STUDY DESIGN:Prospective study with 12-month follow-up.OBJECTIVE:To examine how the relative severity of low back pain (LBP) to leg/buttock pain (LP) influences the outcome of decompression surgery for spinal stenosis.SUMMARY OF BACKGROUND DATA:Decompression surgery is a common treatment for lumbar spinal canal stenosis, with generally good outcome. However, concomitant LBP at presentation can make it difficult to decide whether decompression alone will result in a good overall outcome.METHODS:The Spine Society of Europe Spine Tango system was used to acquire the data from 221 patients. Inclusion criteria were lumbar degenerative spinal stenosis, first-time surgery, maximum 3 affected levels, and decompression as the only procedure. Before and 12 months after surgery, patients completed the multidimensional Core Outcome Measures Index (COMI; includes 0-10 LP and LBP scales); at 12 months, global outcome was rated on a Likert-scale and dichotomized into "good" and "poor" groups.RESULTS:There was a low but significant positive correlation between baseline LP-minus-LBP scores and both improvement in the multidimensional COMI score after 12 months (r = 0.21, P = 0.003) and the score on the 12-month global outcome scale (r = 0.19, P = 0.007). In the good outcome group, mean baseline LP was 2.3 (+/-3.7) points higher than LBP; in the poor group, the corresponding value was 0.8 (+/-3.4) (P = 0.01 between groups). In multivariate regression analyses (controlling for age, gender, comorbidity), baseline LBP intensity was the most significant predictor of the 12-month COMI score, and preoperative LP-minus-LBP score of the global outcome (each P < 0.05).CONCLUSION:Overall, greater back pain relative to LP at baseline was associated with a significantly worse outcome after decompression. This finding seems intuitive, but has rarely been quantified in the many predictor studies conducted to date. Consideration of relative LBP and LP scores may assist in clinical decision-making and in establishing realistic patient expectations.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Spine. - 34 : 11 (2009), p. 1198-1203. -
További szerzők:Grob, Dieter Lattig, Friederike Bartanusz, Viktor Porchet, Françis Jeszenszky Dezső (1954-) (idegsebész, ortopédus) O'Riordan, David Mannion, Anne F.
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3.

001-es BibID:BIBFORM077971
Első szerző:Lattig, Friederike
Cím:A Comparison of Patient and Surgeon Preoperative Expectations of Spinal Surgery / Friederike Lattig, Tamás Fekete, David O'Riordan, Frank Kleinstück, Dezsö Jeszenszky, François Porchet, Urs Mutter, Anne Mannion
Dátum:2013
ISSN:0362-2436
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Spine. - 38 : 12 (2013), p. 1040-1048. -
További szerzők:Fekete Tamás Fülöp O'Riordan, David Kleinstück, Frank S. Jeszenszky Dezső (1954-) (idegsebész, ortopédus) Porchet, Françis Mutter, Urs Mannion, Anne F.
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4.

001-es BibID:BIBFORM034531
Első szerző:Lattig, Friederike
Cím:Ratings of global outcome at the first post-operative assessment after spinal surgery : how often do the surgeon and patient agree? / Lattig Friederike, Grob Dieter, Kleinstueck Frank S., Porchet Francois, Jeszenszky Dezsö, Bartanusz Viktor, O'Riordan David, Mannion Anne F.
Dátum:2009
ISSN:0940-6719
Megjegyzések:Patient-orientated questionnaires are becoming increasingly popular in the assessment of outcome and are considered to provide a less biased assessment of the surgical result than traditional surgeon-based ratings. The present study sought to quantify the level of agreement between patients' and doctors' global outcome ratings after spine surgery. 1,113 German-speaking patients (59.0 +/- 16.6 years; 643 F, 470 M) who had undergone spine surgery rated the global outcome of the operation 3 months later, using a 5-point scale: operation helped a lot, helped, helped only little, didn't help, made things worse. They also rated pain, function, quality-of-life and disability, using the Core Outcome Measures Index (COMI), and their satisfaction with treatment (5-point scale). The surgeon completed a SSE Spine Tango Follow-up form, blind to the patient's evaluation, rating the outcome with the McNab criteria as excellent, good, fair, and poor. The data were compared, in terms of (1) the correlation between surgeons' and patients' ratings and (2) the proportions of identical ratings, where the doctor's "excellent" was considered equivalent to the patient's "operation helped a lot", "good" to "operation helped", "fair" to "operation helped only little" and "poor" to "operation didn't help/made things worse". There was a significant correlation (Spearman Rho = 0.57, p < 0.0001) between the surgeons' and patients' ratings. Their ratings were identical in 51.2% of the cases; the surgeon gave better ratings than the patient ("overrated") in 25.6% cases and worse ratings ("underrated") in 23.2% cases. There were significant differences between the six surgeons in the degree to which their ratings matched those of the patients, with senior surgeons "overrating" significantly more often than junior surgeons (p < 0.001). "Overrating" was significantly more prevalent for patients with a poor self-rated outcome (measured as global outcome, COMI score, or satisfaction with treatment; each p < 0.001). In a multivariate model controlling for age and gender, "low satisfaction with treatment" and "being a senior surgeon" were the most significant unique predictors of surgeon "overrating" (p < 0.0001; adjusted R (2) = 0.21). Factors with no unique significant influence included comorbidity (ASA score), first time versus repeat surgery, one-level versus multilevel surgery. In conclusion, approximately half of the patient's perceptions of outcome after spine surgery were identical to those of the surgeon. Generally, where discrepancies arose, there was a tendency for the surgeon to be slightly more optimistic than the patient, and more so in relation to patients who themselves declared a poor outcome. This highlights the potential bias in outcome studies that rely solely on surgeon ratings of outcome and indicates the importance of collecting data from both the patient and the surgeon, in order to provide a balanced view of the outcome of spine surgery.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:European Spine Journal. - 18 : S3 (2009), p. 386-394. -
További szerzők:Grob, Dieter Kleinstück, Frank S. Porchet, Françis Jeszenszky Dezső (1954-) (idegsebész, ortopédus) Bartanusz, Viktor O'Riordan, David Mannion, Anne F.
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5.

001-es BibID:BIBFORM080627
Első szerző:Mannion, Anne F.
Cím:The bothersomeness of patient self-rated "complications" reported 1 year after spine surgery / A. F. Mannion, U. M. Mutter, F. T. Fekete, D. O'Riordan, D. Jeszenszky, F. S. Kleinstueck, F. Lattig, D. Grob, F. Porchet
Dátum:2012
ISSN:0940-6719
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:European Spine Journal. - 21 : 8 (2012), p. 1625-1632. -
További szerzők:Mutter, Urs Fekete Tamás Fülöp O'Riordan, David Jeszenszky Dezső (1954-) (idegsebész, ortopédus) Kleinstück, Frank S. Lattig, Friederike Grob, Dieter Porchet, Françis
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6.

001-es BibID:BIBFORM077976
Első szerző:Mannion, Anne F.
Cím:The assessment of complications after spine surgery: time for a paradigm shift? / Anne F. Mannion, Tamas F. Fekete, David O'Riordan, François Porchet, Urs M. Mutter, Dezsö Jeszenszky, Friederike Lattig, Dieter Grob, Frank S. Kleinstueck
Dátum:2013
ISSN:1529-9430
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:The Spine Journal. - 13 : 6 (2013), p. 615-624. -
További szerzők:Fekete Tamás Fülöp O'Riordan, David Porchet, Françis Mutter, Urs Jeszenszky Dezső (1954-) (idegsebész, ortopédus) Lattig, Friederike Grob, Dieter Kleinstück, Frank S.
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7.

001-es BibID:BIBFORM034536
Első szerző:Porchet, Françis
Cím:Comparison of patient and surgeon ratings of outcome 12 months after spine surgery / Porchet Francois, Lattig Friederike, Grob Dieter, Kleinstueck Frank S., Jeszenszky Dezsö, Paus Christophe, O'Riordan David, Mannion Anne F.
Dátum:2010
ISSN:1547-5654
Megjegyzések:OBJECT:The contemporary assessment of spine surgical outcome primarily relies on patient-centered reports of symptoms and function. Such measures are considered to reduce bias compared with traditional surgeon-based outcome ratings. This study examined the agreement between patients' and surgeons' ratings of outcome 1 year after spine surgery.METHODS:The study involved 404 patients (mean age 56.6 +/- 16.4 years; 259 women, 145 men) and their treating surgeons. At baseline and 12 months postoperatively patients completed the Core Outcome Measures Index (COMI) rating pain, function, quality of life, and disability. At 12 months postoperatively, they also rated the global outcome of surgery and their satisfaction with treatment. The surgeon, blinded to the patient's evaluation, rated the global outcome of surgery as excellent, good, fair, or poor.RESULTS:Seventy-six percent of the patients who were considered by the surgeon to have an excellent or good outcome achieved the minimum clinically important difference (MCID) of a 2.2-point reduction on the COMI; 24% achieved less than the MCID. There was a significant correlation between the surgeons' and patients' global outcome ratings (Spearman rho = 0.56; p < 0.0001). The degree of absolute agreement between them was significantly influenced by surgeon seniority: senior surgeons "overrated" the outcome in 24.5% of cases (compared with patients' ratings) and "underrated" it in 17.5% of cases. Junior surgeons overrated in 7.8% of cases and underrated in 43.8% of cases (p < 0.0001). Surgeon overrating occurred significantly more frequently for patients with a poor self-rated outcome (measured as global outcome, COMI score, or satisfaction with treatment). In a multivariate model, the independent variables "senior surgeon" and "patient dissatisfaction with care" were the most significant unique predictors of surgeon overrating of the global outcome (p < 0.0001; adjusted R(2) for the model = 0.16).CONCLUSIONS:Overall, agreement between surgeon and patient was reasonably good. The majority of patients who were rated as excellent/good by the surgeons had achieved the MCID in the prospectively measured COMI score. Discrepancies in outcome ratings were influenced by surgeon seniority and patient satisfaction. For a balanced view of the surgical result, outcomes should be assessed from the perspectives of both the patient and the surgeon.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Journal Of Neurosurgery-Spine. - 12 : 5 (2010), p. 447-455. -
További szerzők:Lattig, Friederike Grob, Dieter Kleinstück, Frank S. Jeszenszky Dezső (1954-) (idegsebész, ortopédus) Paus, Christophe O'Riordan, David Mannion, Anne F.
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